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Updated: Jun 5, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Sleep disturbances and suicidal ideation in sleep medical center patients
Barry Krakow1, Jessica D Ribeiro, Victor A Ulibarri
1Sleep & Human Health Institute, Albuquerque, NM, USA. bkrakow@sleeptreatment.com
Objective:
The purpose of this investigation was two-fold: first, we examined associations between suicidal ideation, maladaptive sleep patterns and abnormal sleep behaviors in a sleep center population, an understudied population in the domain of suicide research; and then, we explored whether significant associations remained after accounting for the possible influence of depressive symptoms.
Method:
Data were analyzed from intake information obtained from 1584 adult patients presenting at a community-based private sleep medical center. The sample was parsed into a Suicidal Ideation (SI) group (N=211) and No Suicidal Ideation (NSI) group (N=1373). Comparisons of these groups were made on measures of self-reported sleep complaints, habits, and behaviors, suicidal ideation, depressive symptoms, and associated psychopathology.
Results:
Approximately 13% of participants reported suicidal ideation. Clinically significant suicidal ideation was present in 4.5% of the sample. Compared to the NSI group, the SI group showed a pervasive pattern of significantly greater frequency or severity of sleep problems in areas of insomnia, nightmares and other parasomnia behaviors, poor sleep quality, and sleep-related psychophysiologic conditioning as well as worse sleep-related impairment and quality of life. Several relationships were significant after controlling for depressive symptoms.
Discussion:
Suicidal ideation was consistently associated with a broad array of sleep complaints, even when controlling for level of depressive symptoms. As these self-reported sleep disturbances are treatable sleep disorders, future research should examine the efficacy of sleep and behavioral medicine for reducing the risk of suicidal ideation.
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